Impotence and high blood pressure

Blood pressure plays an extremely important role in the erection process, which is why impotence tends to be prevalent in men with high blood pressure (also known as hypertension). If you have high blood pressure and impotence has been affecting you, you can read further information below regarding the connection and treatment options.

What is the link between erectile dysfunction and high blood pressure?

Impotence in men is one symptom of high blood pressure as the condition can prevent an effective blood flow around the body. This doesn't mean you will definitely get erectile dysfunction if you have a high blood pressure, but there is an increased risk. In fact, one study by the UK government has found that approximately 30% of men diagnosed with high blood pressure also have erectile dysfunction. The figure could be higher if men choose not to seek treatment for impotence as well, or haven't been diagnosed with hypertension yet.

Why does it happen?

The decrease in blood flow that high blood pressure causes makes it difficult to achieve and maintain an erection. Less blood is flowing freely around the body due to the arteries becoming narrower - this includes the genitalia area - meaning the blood vessels aren't widening enough to cause an erection when aroused.

Frustratingly, certain high blood pressure medications list impotence as a possible side effect. What to do in this circumstance is mentioned in a paragraph further down. High blood pressure can also cause a low sex drive and issues with ejaculation. These are different from erectile dysfunction and are treated in other ways.

The physical cause of erectile dysfunction linked to high blood pressure is the movement of blood around the body, however, there's a secondary factor as well. High blood pressure can have an effect on testosterone levels, which can also lead to impotence and even depression. Testosterone plays an important role in male sexual dysfunction, and if testosterone levels are lower than they should be, it can cause an imbalance. This makes it difficult for a man to get or maintain an erection that is sufficient for satisfactory sexual intercourse.

Lastly, erectile dysfunction can cause psychological implications such as anxiety and stress. This can obviously exacerbate the condition further and lead to you avoiding any form of sexual intercourse.

Due to the relation with blood, erectile dysfunction is linked to diabetes and high cholesterol as well as high blood pressure.

How common is having erectile dysfunction and high blood pressure?

Statistics show that around a third of men with high blood pressure are likely to experience impotence, also known as erectile dysfunction. This is also why impotence can be an indication that a man may have high blood pressure and why it's always wise to visit your doctor if erectile dysfunction is a frequent occurrence for you.

By preventing or maintaining a normal blood pressure, you can in turn reduce the effect of erectile dysfunction. Impotence when linked to another condition can often be reversed. Monitoring lifestyle choices, such as the examples below, can help do this.

Lifestyle choices that can reduce the risk high blood pressure and erectile dysfunction

Unhealthy lifestyle choices such as smoking can perpetuate the problem. Here are a number of factors.

Stop smoking – or at least reduce

Healthy diet – limiting salt intake

Reducing alcohol consumption

Losing weight

Exercise regime

Adopting a healthier lifestyle can hugely benefit your self-esteem as well as having a physical direct benefit on your health. With an improved confidence and leaner physique, this can translate to your sex life.

Smoking damages blood vessels. This means the blood flow around the body is affected, including blood flow to the penis. Smoking has a direct link to high blood pressure and erectile dysfunction as well as a wide spectrum of other conditions. Quitting smoking will always be highly advised by any medical professional.

Dr Hilary Jones Independent Medical Adviser

Still not sure? Take our free consultation to find the right treatment for you.

Start Free Consultation

Can high blood pressure medications cause erectile dysfunction?

High blood pressure treatments such as beta-blockers and diuretics in particular may carry a risk of causing impotence as a side effect. This is because diuretics lower the force of blood going towards the penile tissues and beta-blockers can have an effect on nerve responses.

Diuretics (water pill) can cause ED as they decrease the blood flow around the body including the penis and can decrease the amount of zinc in the blood flow, which is used to make testosterone.

Beta-blockers can cause impotence as they also decrease the blood flow to the penis, in a different way to diuretics, by reducing the sensitivity of nerves and stopping the arteries from widening. Beta-blockers can also affect the brain making you feel tired and/or depressed, and therefore affecting your self-confidence. Medications include metoprolol, atenolol, propranolol and carvedilol.

Approximately 40% of men with hypertension also experience erectile dysfunction. The link between erectile dysfunction and hypertension medications is frustrating, as you must take action to manage high blood pressure.

One study found that an analysis of cardio fitness must be thoroughly reviewed, in particularly in connection with sexual intercourse. Some medical professionals suggest using "angiotensin-receptor blocker (used for hypertension) followed by an angiotensin-converting enzyme inhibitor (used for heart conditions and congestive heart failure) or calcium channel blocker (used for high blood pressure)". PDE-5 inhibitors are the first option when treating erectile dysfunction and can be used with these 3 types of hypertension treatment.

If you are concern about impotence as a side effect of your medication, do speak to your doctor. ED will not affect every man taking these medications, so you may consider taking your chosen treatment to see the reaction. Always take prescription medication exactly as prescribed by your doctor and the read the patient leaflet thoroughly before use.

High blood pressure medications less likely to cause impotence

Whilst it's important to realise that impotence is only a possible side effect of certain high blood pressure medications and not a certainty, if you happen to be in this minority there are other options to consider.

Angiotensin-converting enzyme (ACE) inhibitors

Angiotensin II receptor blockers

Alpha blockers

Calcium channel blockers

These types of hypertension medications include Amlodipine, Lisinopril and Ramipril.

It is highly likely you'll be able to take hypertension medication as well as impotence medication together. This includes the familiar names Viagra, Sildenafil, Levitra and Cialis. However, you must inform your doctor if you wish to take a combination of medications to ensure they will be effective and safe for you to use.

Can impotence as a result of high blood pressure be treated?

Impotence as a result of hypertension can be treated. Sometimes simply treating high blood pressure can be helpful, but as mentioned some treatments may contribute to the problem. In these cases it's advisable to work with your doctor to see if alternative treatments or dosage adjustments can help with the issue. You do not have to remain silent if you wish to address both of the conditions.

Impotence Medications

Depending on your health condition and the current treatment you are on for your hypertension, your doctor may likely recommend impotence treatments such as Viagra, Cialis or Levitra. These medications are for erectile dysfunction and not connected with a low libido.

Dr Hilary Jones Independent Medical Adviser

Still not sure? Take our free consultation to find the right treatment for you.

Start Free Consultation

You may not be able to take these treatments if you are using alpha-blockers for hypertension, nitrate treatments for chest pain, have had a heart attack within the previous 6 months or have kidney disease, liver disease or certain types of eye disease.

In cases where it's not possible to use these treatments for impotence, you may be able to benefit from using penis pumps, injections or surgery, although the latter should only be considered as a last resort.

Surgery

The last port of call should always be surgery. Once you have exhausted all the above options, you can consider a penile implant.

This can be in the form of a flexible rod placed in the penis or an inflatable implant that stores fluid under the skin of the abdomen or scrotum, which is then pumped when needed. The flexible rod can be bent up for sex.

Advice for your partner

Erectile dysfunction can have a detrimental effect on your relationships. The key is communication. Involve your partner in your recovery. In terms of lifestyle factors such as exercising and a healthier diet, two heads are better than one.

Dr Hilary Jones Independent Medical Adviser

Still not sure? Take our free consultation to find the right treatment for you.

You can complete a free consultation online to be reviewed by one of our partner doctors. Our Customer Service are on hand to answer any queries or you can order over the phone. Contact us directly Monday to Friday 8am-5:30pm through email, Live Chat or telephone.